@article{3e0952f3ba554f76ad61e0bf261d61ec,
title = "Employing policy and purchasing levers to increase the use of evidence-based practices in community-based substance abuse treatment settings: Reports from single state authorities",
abstract = "State public health authorities are critical to the successful implementation of science based addiction treatment practices by community-based providers. The literature to date, however, lacks examples of state level policy strategies that promote evidence-based practices (EBPs). This mixed-methods study documents changes in two critical state-to-provider strategies aimed at accelerating use of evidence-based practices: purchasing levers (financial incentives and mechanisms) and policy or regulatory levers. A sample of 51 state representatives was interviewed. Single State Authorities for substance abuse treatment (SSAs) that fund providers directly or through managed care were significantly more likely to have contracts that required or encouraged evidence-based interventions, as compared to SSAs that fund providers indirectly through sub-state entities. Policy levers included EBP-related legislation, language in rules and regulations, and evidence-based criteria in state plans and standards. These differences in state policy are likely to result in significant state level variations regarding both the extent to which EBPs are implemented by community-based treatment providers and the quality of implementation.",
keywords = "Evaluation, Evidence-based practices, Implementation, Policy, Purchasing",
author = "Rieckmann, {Traci R.} and Kovas, {Anne E.} and Cassidy, {Elaine F.} and Dennis Mccarty",
note = "Funding Information: North Carolina's Session Law 2001-437 (House Bill 381), “An Act to Phase in Implementation of Mental Health System Reform at the State and Local Level”, was enacted in 2001 and implemented in 2005. The legislative intent was to develop and implement a state plan that promotes best practices, within available resources. The overall goal was for the state to endorse practices and provider choice through training and funding while still allowing some flexibility. North Carolina created new EBP-based service definitions that were integrated into the service array for basic and enhanced services packages. The resulting service options allow providers to offer evidence-based services that may qualify for reimbursement by both Medicaid and state funds. Implementation of North Carolina's legislative mandate is complemented by contracting criteria. North Carolina's SSA contracts indirectly with providers through local management entities (LMEs). SSA-LME contracts require that at least one provider in each LME use an EBP from an approved list. This criterion allows the SSA to endorse and assist provider implementation of EBPs without forcing the issue. Furthermore, the North Carolina Practice Improvement Collaborative of stakeholders – researchers, providers, consumers, advocates – reviews and makes annual recommendations for new EBPs. Although the legislation appropriated no specific funds, the North Carolina SSA state plan is supported financially by the North Carolina Mental Health Trust Fund. Funding Information: Alaska also attempted to mandate EBP use, but no state funds were allocated to support the mandate. With financial support, Alaska's EBP law would have been an ambitious attempt to accelerate EBP use within the state's publicly funded substance abuse treatment programs, and would have provided an interesting contrast to Oregon's mandate. Similarly, trying to work within restricted funding, North Carolina's state plan seeks to integrate EBPs with legislative funding of the Mental Health Trust Fund. However, appropriations to the trust fund are often significantly reduced by competing demands on the state budget. Nevertheless, the North Carolina legislature continues to fund the Practice Improvement Collaborative, which is the SSA's mechanism for studying and disseminating practices. Funding likely will remain a key issue in states{\textquoteright} efforts to improve quality of care through policy ( Bruns et al., 2008; Cooper & Aratani, 2009; Greenhalgh, Robert, MacFarlane, Bate, & Kyriakidou, 2004; Simpson, 2002 ). Indeed, it is recommended that EBP translation and implementation leaders consider funding and policy issues early in the process ( Brown & Flynn, 2002; Rugs et al., 2011; Woolf, 2008 ). ",
year = "2011",
month = nov,
doi = "10.1016/j.evalprogplan.2011.02.003",
language = "English (US)",
volume = "34",
pages = "366--374",
journal = "Evaluation and Program Planning",
issn = "0149-7189",
publisher = "Elsevier Limited",
number = "4",
}